28.  How do you treat a cervical contracture?

Answer:
Cervical contractures should be prevented with splints.  Linear bands can be released with Z-plasties.  Local transposition flaps are normally used.  Bilobed flaps utilizing the acromial skin is one option.  The epaulet flap uses skin from the shoulder but is a poor skin match.  Skin grafts are the most common resurfacing material. It is important to release contractures completely at the time of surgery because that is the maximum improvement attainable and all releases will be subjected to recurrent contractures.
 

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